Leukotriene Receptor Antagonists

Montelukast is a leukotriene antagonist medication with a distinctly shaped tablet. See Figure 5.13.[1]

Mechanism of Action

Montelukast blocks leukotriene receptors and decreases inflammation.

Indications for Use

Montelukast is used for the long-term control of asthma and for decreasing the frequency of asthma attacks.  It is also indicated for exercise-induced bronchospasm and allergic rhinitis.

Nursing Considerations Across the Lifespan

The medication is safe for children 12 months and older. It is available in granule packets and chewable tablets, as well as regular tablets.

Adverse/Side Effects

Montelukast can cause headache, cough, nasal congestion, nausea, and hepatotoxicity.[2]

Photo of Singular brand montelukast tablets
Figure 5.13 Montelukast Tablets

Client Teaching & Education

Clients should be instructed to take medications at the same time each day and at least two hours prior to exercise.  They should not discontinue medications without notifying the healthcare provider.[3]

Montelukast Medication Card

Now let’s take a closer look at the medication card on montelukast.[4][5], [6][7] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.

Medication Card 5.13.1: Montelukast

Class: Leukotriene Receptor Antagonists

Prototypes: Montelukast (Singulair)

Mechanism: Montelukast blocks leukotriene receptors and decreases inflammation

Therapeutic Effects

  • Decreases effects of asthmas long term control
  • Puffy and itchiness of eyes
  • Nasal congestion
  • Runny nose
  • Sneezy

Administration

  • Granule packs 4 mg, chewable tablets 4 and 5 mg, and regular tablets 10mg

Indications

  • Montelukast is used for the long-term control of asthma and for decreasing the frequency of asthma attacks.  It is also indicated for exercise-induced bronchospasm and allergic rhinitis
  • Puffy eyes and itchy
  • Nasal congestion

Contraindications

  • Suicidal Ideation

Side Effects

  • Headache
  • Cough
  • Nasal congestion
  • Nausea
  • Hepatotoxicity
  • Adverse effects Neuropsychiatric events aggression, depression, sleep disturbances, and suicidal behavior and thoughts
  • Safety: This drug has been examined for its potential cause of increasing mental health disorders and suicidal ideation.  In Canada there is discussion about removal of it from practice. Please check to see practice requirements.

Nursing Considerations

  • Can be given to children 12 months and older
  • Take at regular times each day and two hours before exercise
  • Not a rescue drug which means during an acute breathing attack this drug will not help breathing, it is a longer term medication that slows the onset of attacks
  1. "Singulair 10mg" by FedEx is licenced under CC BY-NC-ND 2.0 ↵
  2. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
  3. uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral ↵
  4. This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0. ↵
  5. Frandsen, G. & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer. ↵
  6. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
  7. Adams, M., Holland, N., & Urban, C. (2020). Pharmacology for nurses: A pathophysiologic approach (6th ed.). pp. 622-63 & 626. Pearson. ↵

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Fundamentals of Nursing Pharmacology - Mohawk College Edition Copyright © 2023 by Chippewa Valley Technical College; Amanda Egert; Kimberly Lee; and Manu Gill is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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